RI has 'a lot to do' on Obamacare enrollments; fewer than a quarter are young

Sunday

Jan 13, 2013 at 12:01 AM

Halfway through the enrollment period for individuals, Rhode Island’s health insurance exchange has signed up 32,000 people — more than a third of them taking private insurance.

By Felice J. Freyer

Halfway through the enrollment period for individuals, Rhode Island’s health insurance exchange has signed up 32,000 people — more than a third of them taking private insurance.

The latest data from HealthSource RI, released Monday, shows that from Oct. 1, 2013, through Jan. 4, 2014, 11,770 people signed up to buy private health insurance on their own, 19,941 enrolled in Medicaid, and 530 enrolled through their small-business employer.

However, about a sixth of those who selected a private health insurance plan failed to pay their first-month premium. Those people will not be covered this month, but could get covered starting Feb. 1 if they pay by Jan. 23.

Among those buying private insurance, more than half were age 45 or older, while 23 percent fell into the key 18-to-34 demographic — fewer than the exchange would like to have to balance out the older, costlier enrollees.

“I’m not disappointed,” Christine C. Ferguson, HealthSource RI director, said of the latest numbers. “I think we’ve made a good dent. There’s still a lot to do.”

Ferguson said she expected interest to drop after the Dec. 31 deadline, but instead it has held strong. “We’re still getting very high call volumes and very high web inquiries,” she said. But she declined to predict where enrollment would stand by the March 31 deadline.

Rhode Island is way ahead of the Obama administration’s state target of enrolling 3,600 in private insurance by the end of last year (and 12,000 by March 31).

But that target was clearly lower than most expectations. Blue Cross & Blue Shield of Rhode Island had expected 40,000 by March 31. A state estimate prepared in 2012 projected 62,000 individuals would have private insurance after the end of 2014. Last fall, Ferguson estimated that 70,000 to 100,000 people would get coverage through the exchange during its first 18 months.

HealthSource RI is the state agency carrying out the federal health care overhaul in Rhode Island. It is separate from the trouble-plagued federal exchange in use in 36 states and generally has been performing better.

HealthSource RI is selling insurance to people who buy on their own, rather than through their employers, and also to businesses with 50 or fewer employees. The agency is also helping carry out another key aspect of the law — the expansion of Medicaid to include childless adults, a population estimated at 45,000.

It is not yet known how many of the nearly 20,000 newly enrolled in Medicaid are people who became eligible for the first time this year and how many are people who would have been eligible last year but hadn’t signed up (a population estimated at 19,000).

It’s also not clear how many of the Health Source RI private-insurance enrollees had previously been uninsured. When people apply, the questionnaire asks merely whether they have coverage on that day, not whether they were without insurance in the previous year. HealthSource RI may conduct a survey to find out, Ferguson said.

Among those buying private health insurance, the vast majority — about 87 percent — qualified for federal subsidies to help pay for their premiums or out-of-pocket costs.

Ferguson said she wasn’t surprised that most enrollees were older, because older people have had insurance before and are more likely to be aware of its importance. HealthSource RI plans an intensified marketing campaign targeting younger people, to start soon.

The government, she said, faces the unaccustomed task of selling a product. “Normally in the government environment, we either provide something required by law or provide something that doesn’t have a cost to the individual. In this case, it’s really marketing and selling.”

The new data provide, for the first time, the breakdown between the two health insurers offering plans to the individuals — Blue Cross and Neighborhood Health Plan of Rhode Island.

Blue Cross was the clear winner with 11,417, or 97 percent, of the total. Neighborhood, which only sold plans to people with incomes below 250 percent of the federal poverty level, is new to the commercial market. Before this year, it worked exclusively with Medicaid recipients.

“Neighborhood has not really established its brand in the middle class and other populations,” Ferguson said. “It’s going to take a little time for people to be comfortable and know more about it.”

She is negotiating with both Tufts Health Plan and UnitedHealthcare of New England to also offer health insurance to individuals next year.

Although small employers are a key focus of HealthSource RI, that effort is getting off the ground slowly. Enrollment didn’t start until Nov. 15 and employers don’t face a March 31 deadline; they can sign up throughout the year as their current plans come up for renewal.

So far, 925 employers have started the process of applying, but only 75 have enrolled. These employers have a total of 530 workers covered by their plans. An estimated 30,000 Rhode Island businesses have 50 or fewer workers, and half of them offer health insurance.

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